closes at approx 2 months Which of these is normal? o Soft and Flat o Sunken o Bulging Infant Assessment: Neurological Your charting on a 1-month-old infant will include: Anterior and posterior fontanel, purposeful movement, radial pulse Anterior and posterior fontanel, purposeful movement, brachial pulse Anterior fontanel only, spontaneous movement, radial pulse Anterior and posterior fontanel, spontaneous movement, brachial pulse Infant Reflexes Present and disappear at certain ages Moro – birth to 6 months; support for head/neck lost, sudden movement, loud noise o Fully present at birth disappears 5mo age
o Absent/reappearance CNS damage Tonic Neck – birth to 4 months o ‘Fencing’ reflex; if baby rolls onto face, will roll off o Arm & leg on side face is turning will extend & opposite will flex Rooting – birth to 3-6 months; turns head toward stimulus on cheek Sucking – birth to 10-12 months; suck on any object placed in mouth Palmar grasp – birth to 3-4 months; Plantar grasp – birth to 3-4 months; Stepping – disappears 2-3mo will not be seen until learn to walk on own Babinski – birth to ~ 1 year; stroke foot & toes fan Infant Reflexes should be present at a certain time and then disappear. If they: o Are never present o Don’t go away by the time they should o Go away and come back Infant Reflexes: Video Asymmetric Tonic Neck Reflex (Fencing) Growth and Development Recumbent (laying down) height (cm), weight (naked kg), and head circumference taken every visit and plotted on growth chart o Avg wt of NB 7lbs By 6 months of age the child should have doubled the birth weight By 1 year of age the child’s birth weight should have tripled By 1 year of age the child should have increased in length by 50% Well Child Checks WCC – routine intervals, babies go a lot o Let’s Review: Measurements Plot this: Birth: 3.6 kg 2 days: 3.3 kg – ok but want to see regain by 2wk visit 2 weeks: 3.8 kg 1 mo: 4.2 kg 2 mo: 5.2 kg 4 mo: 6.6 kg 6 mo: 7.6 kg 9 mo: 8.8 kg – dip; crawling/mobile – burning calories 12 mo: 10.6 o Percentile: lower percentile doesn’t mean less healthy, want them to stay along their percentile! o Weight should increase at same interval/speed o Major jumps or falls from percentiles = concerning Developmental Milestones: 0-3 Months o Boxes add on each other
Developmental Milestones: 4-6 Months o Belly to back first! Can use arms & core o Back to front – less help/muscles – older babies o Wait until 6mo to introduce foods o Observe & explore objects – passing Developmental Milestones: 7-9 Months
Developmental Milestones: 10-12 Months Denver Developmental Screen (DON’T MEMORIZE) o Developmental Milestones vary slightly from one child to the next o Evaluate it in context o Child will focus on one area at a time (language or motor skills)
You are the nurse in a pediatrician’s office. You are checking in an 8-month-old boy.
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- Spring '17